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Cigarette Smokers are Less Likely to Have Undetectable Viral Loads: Results From Four HIV Clinics.
J Addict Med. 2016 Jan-Feb; 10(1):13-9.JA

Abstract

BACKGROUND

The prevalence of smoking among HIV-infected individuals is 2-3 times that of the general population, increasing the risk of smoking-related morbidity and mortality. We examined characteristics associated with smoking behavior among a large cohort of HIV-infected individuals in care in the United States.

METHODS

A convenience sample of 2952 HIV-infected patients in the Centers for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS) was assessed during routine clinic visits and was included. Multinomial logistic regression was used to examine the relationship between smoking status, depression/panic symptoms, alcohol/substance use, and demographic and clinical characteristics.

RESULTS

Compared with never-smokers, current smokers were more likely to have moderate to severe depression (odds ratio [OR] 1.37), endorse current substance use (OR 14.09), and less likely to report low-risk alcohol use on the Alcohol Use Disorders Identification Test (AUDIT-C) (OR 0.73). Current smokers were less likely to have an undetectable viral load (OR 0.75), and more likely to have current substance abuse (OR 2.81) and moderate to severe depression (OR 1.50), relative to smokers who had quit smoking.

CONCLUSIONS

HIV-infected smokers are less likely to have undetectable viral loads and frequently have psychosocial comorbidities including depression and substance abuse that impact antiretroviral therapy adherence and viral load suppression. To be effective, smoking-cessation interventions need to address the complex underlying concurrent risks in this population.

Authors+Show Affiliations

University of Alabama at Birmingham (KLC, JHW, MJM, CMcC, SL, JLR, JES, MSS), Birmingham, AL; University of Washington (HMC, MMK), Seattle, WA; University of California, San Diego (WCM), San Diego, CA; Fenway Community Health Center (SB), Boston, MA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26656939

Citation

Cropsey, Karen L., et al. "Cigarette Smokers Are Less Likely to Have Undetectable Viral Loads: Results From Four HIV Clinics." Journal of Addiction Medicine, vol. 10, no. 1, 2016, pp. 13-9.
Cropsey KL, Willig JH, Mugavero MJ, et al. Cigarette Smokers are Less Likely to Have Undetectable Viral Loads: Results From Four HIV Clinics. J Addict Med. 2016;10(1):13-9.
Cropsey, K. L., Willig, J. H., Mugavero, M. J., Crane, H. M., McCullumsmith, C., Lawrence, S., Raper, J. L., Mathews, W. C., Boswell, S., Kitahata, M. M., Schumacher, J. E., & Saag, M. S. (2016). Cigarette Smokers are Less Likely to Have Undetectable Viral Loads: Results From Four HIV Clinics. Journal of Addiction Medicine, 10(1), 13-9. https://doi.org/10.1097/ADM.0000000000000172
Cropsey KL, et al. Cigarette Smokers Are Less Likely to Have Undetectable Viral Loads: Results From Four HIV Clinics. J Addict Med. 2016 Jan-Feb;10(1):13-9. PubMed PMID: 26656939.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cigarette Smokers are Less Likely to Have Undetectable Viral Loads: Results From Four HIV Clinics. AU - Cropsey,Karen L, AU - Willig,James H, AU - Mugavero,Michael J, AU - Crane,Heidi M, AU - McCullumsmith,Cheryl, AU - Lawrence,Sarah, AU - Raper,James L, AU - Mathews,W Christopher, AU - Boswell,Stephen, AU - Kitahata,Mari M, AU - Schumacher,Joseph E, AU - Saag,Michael S, AU - ,, PY - 2015/12/15/entrez PY - 2015/12/15/pubmed PY - 2016/12/15/medline SP - 13 EP - 9 JF - Journal of addiction medicine JO - J Addict Med VL - 10 IS - 1 N2 - BACKGROUND: The prevalence of smoking among HIV-infected individuals is 2-3 times that of the general population, increasing the risk of smoking-related morbidity and mortality. We examined characteristics associated with smoking behavior among a large cohort of HIV-infected individuals in care in the United States. METHODS: A convenience sample of 2952 HIV-infected patients in the Centers for AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS) was assessed during routine clinic visits and was included. Multinomial logistic regression was used to examine the relationship between smoking status, depression/panic symptoms, alcohol/substance use, and demographic and clinical characteristics. RESULTS: Compared with never-smokers, current smokers were more likely to have moderate to severe depression (odds ratio [OR] 1.37), endorse current substance use (OR 14.09), and less likely to report low-risk alcohol use on the Alcohol Use Disorders Identification Test (AUDIT-C) (OR 0.73). Current smokers were less likely to have an undetectable viral load (OR 0.75), and more likely to have current substance abuse (OR 2.81) and moderate to severe depression (OR 1.50), relative to smokers who had quit smoking. CONCLUSIONS: HIV-infected smokers are less likely to have undetectable viral loads and frequently have psychosocial comorbidities including depression and substance abuse that impact antiretroviral therapy adherence and viral load suppression. To be effective, smoking-cessation interventions need to address the complex underlying concurrent risks in this population. SN - 1935-3227 UR - https://www.unboundmedicine.com/medline/citation/26656939/Cigarette_Smokers_are_Less_Likely_to_Have_Undetectable_Viral_Loads:_Results_From_Four_HIV_Clinics_ L2 - https://doi.org/10.1097/ADM.0000000000000172 DB - PRIME DP - Unbound Medicine ER -